Wixela™ Inhub™ Savings Card Terms and Conditions
This Savings Card can be used to reduce the amount of your out-of-pocket expenses for Wixela™ Inhub™ up to a maximum of $50 per 30-day prescription, after you pay the first $10 per 30-day prescription, while this program remains in effect. No other purchase is necessary. This offer can be used up to a total of 12 times per calendar year, with a savings cap of $600 per calendar year while this program remains in effect. Valid prescription with Prescriber ID# is required. Mylan Pharmaceuticals Inc. reserves the right to amend or end this program at any time without notice.
Eligibility Requirements: This Savings Card can be redeemed only by patients or patient guardians who are 18 years of age or older and who are residents of the United States and its territories. Patients must have commercial insurance. This program is not valid for uninsured patients (but may be used by commercially insured patients without coverage for Wixela™ Inhub™) and patients who are covered by any state or federally funded healthcare program, including but not limited to any state pharmaceutical assistance program, Medicare (Part D or otherwise), Medicaid, Medigap, VA or DOD, or TriCare (regardless of whether Wixela™ Inhub™ is covered by such government program); not valid if the patient is Medicare eligible and enrolled in an employer-sponsored health plan or prescription benefit program for retirees; and not valid if the patient’s insurance plan is paying the entire cost of this prescription. This program is void outside the US and its territories or where prohibited by law, taxed, or restricted. Absent a change in Massachusetts law, this program will no longer be valid for Massachusetts residents after June 30, 2020.
This Savings Card is not health insurance. This Savings Card is not transferable, and the amount of the savings cannot exceed the patient’s out-of-pocket expenses. This program cannot be combined with any other rebate/coupon, free trial, or similar offer for the specified prescription. This Savings Card is not redeemable for cash.
NOTICE: Data related to your use of this Savings Card may be collected, analyzed and shared with Mylan Pharmaceuticals Inc. for market research and other purposes related to assessing coupon programs. Data shared with Mylan Pharmaceuticals Inc. will be aggregated and de-identified, meaning it will be combined with data related to other savings card redemptions and will not identify you.
Patient Instructions: By using this Savings Card, you acknowledge that you currently meet the eligibility criteria and that you understand and will comply with the following additional terms and conditions:
- You have not submitted and will not submit a claim for reimbursement under any federal, state or other governmental programs for this prescription.
- Your use of this Savings Card must be consistent with the terms of any drug benefit provided by your commercial health insurer, health plan, or private third-party payer. You agree to report the use of this Savings Card to your commercial insurer if required.
- Where required, a Savings Card and prescription drug insurance card, along with a valid prescription for Wixela™ Inhub™ must be presented to your pharmacist.
Pharmacist Instructions: When you accept this Savings Card, you are certifying that you have received this Savings Card from an eligible patient; you have received a valid prescription for Wixela™ Inhub™ for an eligible patient; you have dispensed the product as indicated; you have not submitted and will not submit a claim for reimbursement under any federal, state or other governmental programs for this prescription; and you will otherwise comply with these terms and all applicable terms and conditions. You further certify that your participation in this program is consistent with all applicable state laws and any obligations, contractual or otherwise, that you have as a pharmacy provider, and that you will report the use of this Savings Card to the patient’s insurer if required.
- Submit transaction to McKesson Corporation using BIN #610524.
- For commercially insured patients, input this Savings Card information as secondary coverage and transmit using the COB segment of the NCPDP transaction. Applicable patient savings will be displayed in the transaction response.
- Acceptance of this Savings Card and your submission of claims for the Wixela™ Inhub™ Savings Card program are subject to the Savings Card Terms and Conditions posted at www.activatethecard.com/wixela/#tnc.
- Acceptance of this Savings Card and your submission of claims for the Wixela™ Inhub™ Savings Card program are subject to the LoyaltyScript® program Terms and Conditions posted at www.mckesson.com/mprstnc.
- For questions regarding setup, claim transmission, patient eligibility or other issues, call the LoyaltyScript® for the Wixela™ Inhub™ Savings Card program at 800-657-7613 (8:00 AM-8:00 PM EST, Monday-Friday).
Important Safety Information
WIXELA INHUB contains salmeterol, the same medicine found in SEREVENT® (salmeterol xinafoate inhalation powder). LABA medicines such as salmeterol when used alone increase the risk of hospitalizations and death from asthma problems. WIXELA INHUB contains an ICS and a LABA. When an ICS and LABA are used together, there is not a significant increased risk in hospitalizations and death from asthma problems.
Do not use WIXELA INHUB to treat sudden breathing problems from asthma or COPD. Always have a rescue inhaler with you to treat sudden symptoms.
Do not use WIXELA INHUB if you have a severe allergy to milk proteins. Do not use WIXELA INHUB if you are allergic to any of the ingredients in the products. Ask your healthcare provider if you are not sure.
Do not use WIXELA INHUB more often than prescribed.
Do not take WIXELA INHUB with other medicines that contain a LABA for any reason.
Tell your healthcare provider about all the medicines you take and about all of your health conditions.
Call your healthcare provider or get medical care right away if your breathing problems get worse, if you need your rescue inhaler more often than usual or it does not work as well to relieve your symptoms, or if your peak flow meter results decrease. Your healthcare provider will tell you the numbers that are right for you.
WIXELA INHUB can cause serious side effects, including:
- Fungal infection in your mouth or throat (thrush). Rinse your mouth with water without swallowing after using WIXELA INHUB to help reduce your chance of getting thrush.
- Pneumonia. People with COPD have a higher chance of getting pneumonia. WIXELA INHUB may increase the chance of getting pneumonia. Call your healthcare provider if you notice any of the following symptoms: increase in mucus (sputum) production; change in mucus color; fever; chills; increased cough; increased breathing problems.
- Weakened immune system and increased chance of getting infections (immunosuppression). You should avoid exposure to chickenpox and measles, and, if exposed, tell your healthcare provider right away. Worsening of existing tuberculosis, fungal, bacterial, viral, or parasitic infections, or herpes infection of the eye (ocular herpes simplex) may occur.
- Reduced adrenal function. This can happen when you stop taking an oral corticosteroid (such as prednisone) and start taking a medicine containing an inhaled corticosteroid (such as WIXELA INHUB). During this transition period, when your body is under stress such as from fever, trauma (such as a car accident), infection, surgery, or worse COPD symptoms, adrenal insufficiency can get worse and may cause death. Symptoms of adrenal insufficiency include: feeling tired; lack of energy; weakness; nausea and vomiting; low blood pressure (hypotension).
- Sudden breathing problems immediately after inhaling your medicine. If you have sudden breathing problems immediately after inhaling your medicine, stop using WIXELA INHUB and call your healthcare provider right away.
- Serious allergic reactions. Call your healthcare provider or get emergency medical care if you get any of the following symptoms of a serious allergic reaction: rash; hives; swelling of your face, mouth, and tongue; breathing problems.
- Effects on heart: increased blood pressure; a fast or irregular heartbeat; chest pain.
- Effects on nervous system: tremor; nervousness.
- Bone thinning or weakness (osteoporosis).
- Slowed growth in children. A child's growth should be checked regularly by the healthcare provider.
- Eye problems including glaucoma, increased pressure in your eye, cataracts, or other changes in vision. You should have regular eye exams while using WIXELA INHUB.
- Changes in laboratory blood values (sugar, potassium, certain types of white blood cells).
Common side effects of WIXELA INHUB for asthma include upper respiratory tract infection, throat irritation, hoarseness and voice changes, thrush in your mouth or throat, bronchitis, cough, headache, and nausea and vomiting. In children with asthma, infections in the ear, nose, and throat are common.
Common side effects of WIXELA INHUB for COPD include thrush in your mouth or throat, throat irritation, hoarseness and voice changes, viral respiratory infections, headache, and muscle and bone pain.
WIXELA INHUB is a twice-daily prescription medicine used to control symptoms of asthma and to prevent symptoms such as wheezing in patients 4 years and older. WIXELA INHUB is for adults and children with asthma who are not well controlled with an asthma control medicine, such as an inhaled corticosteroid (ICS) medicine and need both an ICS and long-acting beta2-adrenergic agonist (LABA) medicine.
WIXELA INHUB 250/50 is a twice-daily prescription medicine used long term to treat chronic obstructive pulmonary disease (COPD), including chronic bronchitis, emphysema, or both, for better breathing and fewer flare-ups.
WIXELA INHUB is not used to relieve sudden breathing problems from asthma or COPD and won't replace a rescue inhaler.
Please see accompanying full Prescribing Information and Patient Information.
For additional information, please contact Mylan at 800-395-3376.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.FDA.gov/medwatch, or call 1-800-FDA-1088.